I 

118TH CONGRESS 

2D SESSION H. R. 9049 

To amend title XIX of the Social Security Act to provide States with the 

option to provide coordinated care through a pregnancy medical home 

for high-risk pregnant women, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 15, 2024 

Mr. NUNN of Iowa (for himself, Ms. UNDERWOOD, and Ms. PRESSLEY) introduced the following bill; which was referred to the Committee on Energy 

and Commerce 

A BILL 

To amend title XIX of the Social Security Act to provide 

States with the option to provide coordinated care 

through a pregnancy medical home for high-risk pregnant women, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Harnessing Effective 

5 and Appropriate Long-Term Health for Moms On Med6 icaid Act of 2024’’ or the ‘‘HEALTH for MOM Act of 

7 2024’’. 


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1 SEC. 2. STATE OPTION TO PROVIDE COORDINATED CARE 

2 THROUGH A HEALTH HOME FOR PREGNANT 

3 AND POSTPARTUM WOMEN. 

4 Title XIX of the Social Security Act (42 U.S.C. 1396 

5 et seq.) is amended by inserting after section 1945A the 

6 following new section: 

7 ‘‘SEC. 1945B. STATE OPTION TO PROVIDE COORDINATED 

8 CARE THROUGH A HEALTH HOME FOR PREG9 NANT AND POSTPARTUM WOMEN. 

10 ‘‘(a) STATE OPTION.— 

11 ‘‘(1) IN GENERAL.—Notwithstanding section 

12 1902(a)(1) (relating to statewideness) and section 

13 1902(a)(10)(B) (relating to comparability), begin14 ning 2 years after the date of the enactment of this 

15 section, a State, at its option as a State plan amend16 ment and after consultation with health care pro17 viders and individuals enrolled under such plan who 

18 are or have been pregnant, may provide for medical 

19 assistance under this title to an eligible woman who 

20 chooses to— 

21 ‘‘(A) enroll in a maternity health home 

22 under this section by selecting a designated pro23 vider, a team of health care professionals oper24 ating with such a provider, or a health team as 

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1 poses of providing the woman with pregnancy 

2 and postpartum coordinated care services; or 

3 ‘‘(B) receive such services from a des4 ignated provider, a team of health care profes5 sionals operating with such a provider, or a 

6 health team that has voluntarily opted to par7 ticipate in a maternity health home for eligible 

8 women under this section. 

9 ‘‘(2) ELIGIBLE WOMAN DEFINED.— 

10 ‘‘(A) IN GENERAL.—In this section, the 

11 term ‘eligible woman’ means an individual 

12 who— 

13 ‘‘(i) is eligible for medical assistance 

14 under the State plan (or under a waiver of 

15 such plan) for all items and services cov16 ered under the State plan (or waiver) that 

17 are not less in amount, duration, or scope, 

18 or are determined by the Secretary to be 

19 substantially equivalent, to the medical as20 sistance available for an individual de21 scribed in subsection (a)(10)(A)(i); and 

22 ‘‘(ii) is pregnant. 

23 ‘‘(B) CONTINUATION OF ELIGIBILITY.—An 

24 individual described in subparagraph (A) shall 


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1 be deemed to be described in such subpara2 graph through the earlier of— 

3 ‘‘(i) the end of the month in which the 

4 individual’s eligibility for medical assist5 ance under the State plan (or waiver) 

6 ends; and 

7 ‘‘(ii) the last day of the 1-year period 

8 that begins on the last day of the individ9 ual’s pregnancy. 

10 ‘‘(C) EXCLUSION OF INDIVIDUALS ELIGI11 BLE FOR A LIMITED PREGNANCY-RELATED

12 ONLY BENEFIT PACKAGE.—Such term does not 

13 include an individual who had a pregnancy end 

14 within the last 365 days and whose eligibility 

15 under such plan (or waiver) is limited to cov16 erage for a limited type of benefits and services. 

17 ‘‘(b) QUALIFICATION STANDARDS.—The Secretary 

18 shall establish standards for qualification as a maternity 

19 health home or as a designated provider, team of health 

20 care professionals operating with such a provider, or a 

21 health team eligible for participation in a maternity health 

22 home for purposes of this section. Such standards shall 

23 include requiring designated providers, teams of health 

24 care professionals operating with such providers, and 


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1 health teams (designated as a maternity health home) to 

2 demonstrate to the State the ability to do the following: 

3 ‘‘(1) Coordinate prompt care and access to ma4 ternity and postpartum care services, including serv5 ices provided by specialists, and programs for an eli6 gible woman during pregnancy and during the pe7 riod for which she remains eligible as described in 

8 subsection (a)(2)(B). 

9 ‘‘(2) Develop an individualized, comprehensive, 

10 patient-centered care plan for each eligible woman 

11 that accommodates patient preferences and, if appli12 cable, reflects adjustments to the payment method13 ology described in subsection (c)(2)(B). 

14 ‘‘(3) Develop and incorporate into each eligible 

15 woman’s care plan, in a culturally and linguistically 

16 appropriate manner consistent with the needs of the 

17 eligible woman, ongoing home care, community18 based primary care, inpatient care, social support 

19 services, behavioral health services, local hospital 

20 emergency care, oral health care, and to the extent, 

21 applicable, care management and planning related to 

22 a change in an eligible woman’s eligibility for med23 ical assistance or a change in health insurance cov24 erage. 


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1 ‘‘(4) Coordinate with pediatric care providers, 

2 community-based providers, behavioral health pro3 viders, social service providers, local hospital and 

4 emergency care providers, oral health providers, spe5 cialists, and providers of early intervention services 

6 to ensure full implementation of the client’s care 

7 plan, as appropriate. 

8 ‘‘(5) Collect and report information under sub9 section (f)(1). 

10 ‘‘(c) PAYMENTS.— 

11 ‘‘(1) IN GENERAL.—A State shall provide a des12 ignated provider, a team of health care professionals 

13 operating with such a provider, or a health team 

14 with payments for the provision of pregnancy and 

15 postpartum coordinated care services, to each eligi16 ble woman that selects such provider, team of health 

17 care professionals, or health team as the woman’s 

18 maternity health home or care provider. Payments 

19 made to a maternity health home or care provider 

20 for such services shall be treated as medical assist21 ance for purposes of section 1903(a), except that, 

22 during the first 4 fiscal year quarters that the State 

23 plan amendment is in effect, the Federal medical as24 sistance percentage applicable to such payments 


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1 shall be increased by 15 percentage points, but in no 

2 case may exceed 90 percent. 

3 ‘‘(2) METHODOLOGY.—The State shall specify 

4 in the State plan amendment the methodology the 

5 State will use for determining payment for the provi6 sion of pregnancy and postpartum coordinated care 

7 services or treatment to an eligible woman. Such 

8 methodology for determining payment— 

9 ‘‘(A) may be based on— 

10 ‘‘(i) a per-member per-month basis for 

11 each eligible woman enrolled in the mater12 nity health home; 

13 ‘‘(ii) a prospective payment model, in 

14 the case of payments to Federally qualified 

15 health centers or a rural health clinics; or 

16 ‘‘(iii) an alternate model of payment 

17 (which may include a model developed 

18 under a waiver under section 1115) pro19 posed by the State and approved by the 

20 Secretary; 

21 ‘‘(B) may be adjusted to reflect, with re22 spect to each eligible woman— 

23 ‘‘(i) the severity of the risks associ24 ated with the woman’s pregnancy; 


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1 ‘‘(ii) the severity of the risks associ2 ated with the woman’s postpartum health 

3 care needs; and 

4 ‘‘(iii) the level or amount of time of 

5 care coordination required with respect to 

6 the woman; and 

7 ‘‘(C) shall be established consistent with 

8 section 1902(a)(30)(A). 

9 ‘‘(d) COORDINATING CARE.— 

10 ‘‘(1) HOSPITAL NOTIFICATION.—A State with a 

11 State plan amendment approved under this section 

12 shall require each hospital that is a participating 

13 provider under the State plan (or under a waiver of 

14 such plan) to establish procedures in the case of an 

15 eligible woman who seeks treatment in the emer16 gency department of such hospital for— 

17 ‘‘(A) providing the woman with culturally 

18 and linguistically appropriate information on 

19 the respective treatment models and opportuni20 ties for the woman to access a maternity health 

21 home and its associated benefits; and 

22 ‘‘(B) notifying the maternity health home 

23 in which the woman is enrolled, or the des24 ignated provider, team of health care profes25 sionals operating with such a provider, or 


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1 health team treating the woman, of the wom2 an’s treatment in the emergency department 

3 and of the protocols for the maternity health 

4 home, designated provider, or team to be in5 volved in the woman’s emergency care or post6 discharge care. 

7 ‘‘(2) EDUCATION WITH RESPECT TO AVAIL8 ABILITY OF A MATERNITY HEALTH HOME.— 

9 ‘‘(A) IN GENERAL.—In order for a State 

10 plan amendment to be approved under this sec11 tion, a State shall include in the State plan 

12 amendment a description of the State’s process 

13 for— 

14 ‘‘(i) educating providers participating 

15 in the State plan (or a waiver of such 

16 plan) on the availability of maternity 

17 health homes for eligible women, including 

18 the process by which such providers can 

19 participate in or refer eligible women to an 

20 approved maternity health home or a des21 ignated provider, team of health care pro22 fessionals operating such a provider, or 

23 health team; and 

24 ‘‘(ii) educating eligible women, in a 

25 culturally and linguistically appropriate 


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1 manner, on the availability of maternity 

2 health homes. 

3 ‘‘(B) OUTREACH.—The process established 

4 by the State under subparagraph (A) shall in5 clude the participation of relevant stakeholders 

6 or other public or private organizations or enti7 ties that provide outreach and information on 

8 the availability of health care items and services 

9 to families of individuals eligible to receive med10 ical assistance under the State plan (or a waiv11 er of such plan). 

12 ‘‘(3) MENTAL HEALTH COORDINATION.—A 

13 State with a State plan amendment approved under 

14 this section shall consult and coordinate, as appro15 priate, with the Secretary in addressing issues re16 garding the prevention, identification, and treatment 

17 of mental health conditions and substance use dis18 orders among eligible women. 

19 ‘‘(4) COORDINATION OF SOCIAL AND SUPPORT

20 SERVICES.—A State with a State plan amendment 

21 approved under this section shall consult and coordi22 nate, as appropriate, with the Secretary in estab23 lishing means to connect eligible women receiving 

24 pregnancy and postpartum care coordinated under 

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1 ing services made available under maternal, infant, 

2 and early childhood home visiting programs estab3 lished under section 511, and services made avail4 able under section 330H or title X of the Public 

5 Health Service Act, the Special Supplemental Nutri6 tion Program for Women, Infants, and Children, or 

7 under title V. 

8 ‘‘(e) MONITORING.—A State shall include in the 

9 State plan amendment— 

10 ‘‘(1) a methodology for tracking reductions in 

11 inpatient days and reductions in the total cost of 

12 care resulting from improved care coordination and 

13 management under this section; 

14 ‘‘(2) a proposal for use of health information 

15 technology in providing an eligible woman with preg16 nancy and postpartum coordinated care services as 

17 specified under this section and improving service 

18 delivery and coordination across the care continuum; 

19 and 

20 ‘‘(3) a methodology for tracking prompt and 

21 timely access to medically necessary care for eligible 

22 women from out-of-State providers. 

23 ‘‘(f) DATA COLLECTION.— 

24 ‘‘(1) PROVIDER REPORTING REQUIREMENTS.— 

25 In order to receive payments from a State under 


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1 subsection (c), a maternity health home, or a des2 ignated provider, a team of health care professionals 

3 operating with such a provider, or a health team, 

4 shall report to the State, at such time and in such 

5 form and manner as may be required by the State, 

6 including through a health information exchange or 

7 other public health data sharing entity, the following 

8 information: 

9 ‘‘(A) With respect to each such designated 

10 provider, team of health care professionals oper11 ating with such a provider, and health team 

12 (designated as a maternity health home), the 

13 name, National Provider Identification number, 

14 address, and specific health care services of15 fered to be provided to eligible women who have 

16 selected such provider, team of health care pro17 fessionals, or health team as the women’s ma18 ternity health home. 

19 ‘‘(B) Information on all applicable meas20 ures for determining the quality of services pro21 vided by such provider, team of health care pro22 fessionals, or health team, including, to the ex23 tent applicable, maternal, perinatal, and child 

24 health quality measures under section 1139B. 


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1 ‘‘(C) Such other information as the Sec2 retary shall specify in guidance. 

3 ‘‘(2) STATE REPORTING REQUIREMENTS.— 

4 ‘‘(A) COMPREHENSIVE REPORT.—A State 

5 with a State plan amendment approved under 

6 this section shall report to the Secretary (and, 

7 upon request, to the Medicaid and CHIP Pay8 ment and Access Commission), at such time, 

9 but at a minimum frequency of every 12 

10 months, and in such form and manner deter11 mined by the Secretary to be reasonable and 

12 minimally burdensome, including through a 

13 health information exchange or other public 

14 health data sharing entity, the following infor15 mation: 

16 ‘‘(i) Information described in para17 graph (1). 

18 ‘‘(ii) The number and, to the extent 

19 available and while maintaining all relevant 

20 protecting privacy and confidentially pro21 tections, disaggregated demographic infor22 mation of eligible women who have enrolled 

23 in a maternity health home pursuant to 

24 this section. 


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1 ‘‘(iii) The number of maternity health 

2 homes in the State. 

3 ‘‘(iv) The medical and behavioral 

4 health conditions or factors that contribute 

5 to severe maternal morbidity among eligi6 ble women enrolled in maternity health 

7 homes in the State. 

8 ‘‘(v) The extent to which such women 

9 receive health care items and services 

10 under the State plan before, during, and 

11 after the women’s enrollment in such a 

12 maternity health home. 

13 ‘‘(vi) Where applicable, mortality data 

14 and data for the associated causes of death 

15 for eligible women enrolled in a maternity 

16 health home under this section, in accord17 ance with subsection (g). For deaths occur18 ring postpartum, such data shall distin19 guish between deaths occurring up to 42 

20 days postpartum and deaths occurring be21 tween 43 days to up to 1 year postpartum. 

22 Where applicable, data reported under this 

23 clause shall be reported alongside com24 parable data from a State’s maternal mor25 tality review committee, as established in 


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1 accordance with section 317K(d) of the 

2 Public Health Service Act, for purposes of 

3 further identifying and comparing state4 wide trends in maternal mortality among 

5 populations participating in the maternity 

6 health home under this section. 

7 ‘‘(vii) The type of delivery systems 

8 and payment models used to provide health 

9 home services to eligible individuals en10 rolled in a maternal health home under 

11 such amendment. 

12 ‘‘(viii) Information on hospitalizations, 

13 morbidity, and mortality of eligible individ14 uals and their infants enrolled in a mater15 nal health home in such State alongside 

16 comparable data from a State’s maternal 

17 mortality review committee. 

18 ‘‘(B) IMPLEMENTATION REPORT.—Not 

19 later than 18 months after a State has a State 

20 plan amendment approved under this section, 

21 the State shall submit to the Secretary, and 

22 make publicly available on the appropriate 

23 State website, a report on how the State is im24 plementing the option established under this 


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1 section, including through any best practices 

2 adopted by the State. 

3 ‘‘(g) CONFIDENTIALITY.—A State with a State plan 

4 amendment under this section shall establish confiden5 tiality protections for the purposes of subsection (f)(2)(A) 

6 to ensure, at a minimum, that there is no disclosure by 

7 the State of any identifying information about any specific 

8 eligible woman enrolled in a maternity health home or any 

9 maternal mortality case, and that all relevant confiden10 tiality and privacy protections, including the requirements 

11 under 1902(a)(7)(A), are maintained. 

12 ‘‘(h) RULE OF CONSTRUCTION.—Nothing in this sec13 tion shall be construed to require— 

14 ‘‘(1) an eligible woman to enroll in a maternity 

15 health home under this section; or 

16 ‘‘(2) a designated provider or health team to 

17 act as a maternity health home and provide services 

18 in accordance with this section if the provider or 

19 health team does not voluntarily agree to act as a 

20 maternity health home. 

21 ‘‘(i) PLANNING GRANTS.— 

22 ‘‘(1) IN GENERAL.—Beginning October 1, 

23 2024, from the amount appropriated under para24 graph (2), the Secretary shall award planning grants 

25 to States for purposes of developing and submitting 


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1 a State plan amendment under this section. The 

2 Secretary shall award a grant to each State that ap3 plies for a grant under this subsection, but the Sec4 retary may determine the amount of the grant based 

5 on the merits of the application and the goal of the 

6 State to prioritize health outcomes for eligible 

7 women. A planning grant awarded to a State under 

8 this subsection shall remain available until expended. 

9 ‘‘(2) APPROPRIATION.—There are authorized to 

10 be appropriated to the Secretary $50,000,000 for 

11 the 2-year period beginning on the date of the enact12 ment of this section, for the purposes of making 

13 grants under this subsection, to remain available 

14 until expended. 

15 ‘‘(3) LIMITATION.—The total amount of pay16 ments made to States under this subsection shall not 

17 exceed $50,000,000. 

18 ‘‘(j) ADDITIONAL DEFINITIONS.—In this section: 

19 ‘‘(1) DESIGNATED PROVIDER.—The term ‘des20 ignated provider’ means a physician (including an 

21 obstetrician-gynecologist), hospital, clinical practice 

22 or clinical group practice, rural clinic, community 

23 health center, community mental health center, or 

24 any other entity or provider that is determined by 

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1 fied to be a maternity health home on the basis of 

2 documentation evidencing that the entity has the 

3 systems, expertise, and infrastructure in place to 

4 provide pregnancy and postpartum coordinated care 

5 services. Such term may include providers who are 

6 employed by, or affiliated with, a hospital. 

7 ‘‘(2) MATERNITY HEALTH HOME.—The term 

8 ‘maternity health home’ means a designated provider 

9 (including a provider that operates in coordination 

10 with a team of health care professionals) or a health 

11 team is selected by an eligible woman to provide 

12 pregnancy and postpartum coordinated care services. 

13 ‘‘(3) HEALTH TEAM.—The term ‘health team’ 

14 has the meaning given such term for purposes of 

15 section 3502 of Public Law 111–148. 

16 ‘‘(4) PREGNANCY AND POSTPARTUM COORDI17 NATED CARE SERVICES.— 

18 ‘‘(A) IN GENERAL.—The term ‘pregnancy 

19 and postpartum coordinated care services’ 

20 means items and services related to the coordi21 nation of care for comprehensive and timely 

22 high-quality, culturally and linguistically appro23 priate, services described in subparagraph (B) 

24 that are provided to an eligible woman by a 

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1 fessionals operating with such a provider, or a 

2 health team (designated as a maternity health 

3 home). 

4 ‘‘(B) SERVICES DESCRIBED.— 

5 ‘‘(i) IN GENERAL.—The services de6 scribed in this subparagraph shall include 

7 with respect to a State electing the State 

8 plan amendment option under this section, 

9 any medical assistance for items and serv10 ices for which payment is available under 

11 the State plan or under a waiver of such 

12 plan. 

13 ‘‘(ii) OTHER ITEMS AND SERVICES.— 

14 In addition to medical assistance described 

15 in clause (i), the services described in this 

16 subparagraph shall include the following: 

17 ‘‘(I) Comprehensive care manage18 ment. 

19 ‘‘(II) Care coordination (includ20 ing with pediatricians, specialists, and 

21 providers of early intervention serv22 ices, as appropriate), health pro23 motion, and providing access to the 

24 full range of maternal, obstetric, and 


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1 gynecologic services, including services 

2 from out-of-State providers. 

3 ‘‘(III) Comprehensive transitional 

4 care, including appropriate follow-up, 

5 from inpatient to other settings. 

6 ‘‘(IV) Patient and family support 

7 (including authorized representatives). 

8 ‘‘(V) Referrals to community and 

9 social support services, if relevant. 

10 ‘‘(VI) Use of health information 

11 technology to link services, as feasible 

12 and appropriate. 

13 ‘‘(5) TEAM OF HEALTH CARE PROFES14 SIONALS.—The term ‘team of health care profes15 sionals’ means a team of health care professionals 

16 (as described in the State plan amendment under 

17 this section) that may— 

18 ‘‘(A) include— 

19 ‘‘(i) physicians, including gynecologist20 obstetricians, pediatricians, and other pro21 fessionals such as physicians assistants, 

22 advance practice nurses, including certified 

23 midwives, nurses, nurse care coordinators, 

24 dietitians, nutritionists, social workers, be25 havioral health professionals, physical 


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1 counselors, physical therapists, occupa2 tional therapists, or any professionals that 

3 assist in prenatal care, delivery, or 

4 postpartum care for which medical assist5 ance is available under the State plan or a 

6 waiver of such plan and determined to be 

7 appropriate by the State and approved by 

8 the Secretary; 

9 ‘‘(ii) an entity or individual who is 

10 designated to coordinate such care deliv11 ered by the team; and 

12 ‘‘(iii) when appropriate and if other13 wise eligible to furnish items and services 

14 that are reimbursable as medical assist15 ance under the State plan or under a waiv16 er of such plan, doulas, community health 

17 workers, translators and interpreters, and 

18 other individuals with culturally appro19 priate and trauma-informed expertise; and 

20 ‘‘(B) provide care at a facility that is free21 standing, virtual, or based at a hospital, com22 munity health center, community mental health 

23 center, rural clinic, clinical practice or clinical 

24 group practice, academic health center, or any 

25 entity determined to be appropriate by the 


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1 State and approved by the Secretary, or provide 

2 care at the home of an individual with respect 

3 to a home birth.’’. 

Æ 


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